3KU-23696-99515

3 vaccinations 9 coded responses 27 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 125 / NY
Registered: 2021-03-10

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Moderna
2021-03-10
Health check-in — day 0, dose 1
Feeling: Good · Nausea

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-18
Survey response — day 7, dose 2
MedDRA: Arthralgia, Headache, Malaise — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: I was very sick the two days after the shot. Pounding headache, joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 28, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Ears ringing loudly for past two weeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 35, dose 2
MedDRA: Office visit, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Both my ears are ringing loudly, and it is non dtop · Healthcare visit (other): Doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: Loud ringing in ears for months. Since about a month after the second shot. I didn't know if it's related, but it never happened prior to the shots

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Dose 3 — Moderna
2022-01-05
Survey response — day 7, dose 3
MedDRA: Fatigue — Feeling: Poor · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Exhausted

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — day 14, dose 3
MedDRA: Chills, Cough, Fatigue, Pain, Pyrexia, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school

Free text: Fever, chills, cough, aches, exhausted.Tested positive for COVID.

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Survey response — day 21, dose 3
MedDRA: Brain fog, Cough, Dizziness, Fatigue, Medical counselling — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Exhausted, light headed, cough. Brain fog · Healthcare visit (other): Phone visit with doctor

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-26
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-02
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-30
Survey response — 3 months, dose 3
MedDRA: Cough — Feeling: Good

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-31
Survey response — 12 months, dose 3
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constant exhaustion

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna
3	2021-12-29	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 7, dose 2

2021-04-18

Systemic reaction (other): I was very sick the two days after the shot. Pounding headache, joint pain

Release 8 — day 28, dose 2

2021-05-05

Symptoms: Ears ringing loudly for past two weeks

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Both my ears are ringing loudly, and it is non dtop

Healthcare visit (other): Doctor visit

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Loud ringing in ears for months. Since about a month after the second shot. I didn't know if it's related, but it never happened prior to the shots

Release 10 — day 7, dose 3

2022-01-05

Systemic reaction (other): Exhausted

Release 10 — day 14, dose 3

2022-01-12

Symptoms: Fever, chills, cough, aches, exhausted.Tested positive for COVID.

Release 10 — day 21, dose 3

2022-01-19

Symptoms: Exhausted, light headed, cough. Brain fog

Healthcare visit (other): Phone visit with doctor

Release 11 — 3 months, dose 3

2022-03-30

Symptoms: Cough

Release 12 — 12 months, dose 3

2022-12-31

Symptoms: Constant exhaustion

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Tinnitus	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release